Wednesday, June 2, 2010

Will ObamaCare Ever Become More Popular?

"Igor Volsky reports that public opinion toward healthcare reform is starting to thaw a bit . . . Stay tuned. I expect these numbers to get slowly better over time. They might or might not shift enough to make a difference in November's election, but they're going to shift.”

Why is Drum so sure that there will be a surge in ObamaCare’s popularity? Maybe it’s just his statistical expectation that shockingly low polling numbers will regress toward the mean—any policy backed by a recently elected president and a large congressional majority that’s as unpopular as ObamaCare is likely to get somewhat more popular over time. That’s plausible, I suppose, but it doesn’t give Drum any reason for thinking that the magnitude of the change in public opinion will make much of an electoral difference over any time frame.

It’s more likely that Drum’s just surrendering to the policy wonk’s natural presumption that people are bound sooner or later to figure out who’s making good public policy. Let’s stipulate that ObamaCare is good public policy in that it’s likely to generate a net increase in aggregate well-being (according to your favorite metric) relative to the feasible alternatives. A moment’s reflection reveals that there’s no necessary connection in democratic politics between doing electorally well and doing public-policy good. It stands to reason that good policy generates political success only insofar as the causal connection between the implementation of the policy and the improvement in many people’s lives (not necessarily one’s own life or the lives of those one cares especially about) is highly visible and widely appreciated.

It's plausible that the people who want health insurance but can’t now secure it, or fear that they’re just one pink slip away from losing the insurance they have will credit ObamaCare for their improved fortunes. But that’s not a very large class of people relative to the universe of likely voters who are satisfied with their present health insurance. Moreover, the size of the class of people who visibly benefit from ObamaCare will vary according to the state of the labor market; its membership will tend to rise and fall along with the unemployment rate. That means that the good done by ObamaCare will become less visible as the economy improves. And if unemployment remains unacceptably high, the public perception of the good ObamaCare does will be offset by the counter-perception that it’s dragging down the economy.

That brings us to the majority of likely voters who are currently satisfied with their health insurance. They’re likely to attribute any decline in their healthcare situation to ObamaCare. That's reasonable enough if they lose their employer-provided health insurance because it induces their employers to pay a fine and dump them into the public exchanges or find themselves paying higher taxes to subsidize other people’s health care, less reasonable if they blame ObamaCare for increases in their insurance premiums that would have risen faster in its absence. But even if ObamaCare’s doing those people some good by decreasing the rate at which their insurance premiums increase, it’s largely invisible--like the jobs “created or saved” by the stimulus bill as unemployment shot up to ten percent. Any good that ObamaCare may do everyone by bending the healthcare cost curve is even harder to spot with the naked eye.

These points reinforce an argument I’ve made before about why the politics of ObamaCare is unlikely to resemble the politics of Social Security and Medicare. I’d love for someone to show me why I’m wrong.